Background to this inspection
Updated
8 November 2022
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.
Inspection team
The inspection was carried out by an inspector, a medicines inspector, medicines manager and Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type
This service provides care and support to people living in eight supported living settings, so they can live as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support.
Registered Manager
This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
At the time of our inspection there was a registered manager in post.
Notice of inspection
We gave the service 48 hours’ notice of the inspection for our first visit. This was because it is a small service and we needed to be sure that the provider or registered manager would be at the service to support the inspection.
Inspection activity started 28 September 2022 and ended on 4 October 2022. We visited the location’s service on the 28 and 30 September and 3 and 4 October 2022.
What we did before the inspection
We reviewed information we had received about the service. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.
During the inspection
We communicated with four people who used the service about their experience of the care provided. Some people who used the service were unable to talk with us and used different ways of communicating including Makaton, photos, symbols, objects and their body language. We also spoke with five people’s relatives.
We spoke with 14 members of staff including the registered manager, the operations manager, field care manager, service manager and 10 support workers. We reviewed a range of records. This included four people's care records and multiple medication records. We looked at multiple staff supervision documents. A variety of records relating to the management of the service, including training records and audits were reviewed.
Updated
8 November 2022
About the service
Voyage (DCA) Greater Manchester is a domiciliary care service, providing personal care and support to people living in Trafford and Bolton. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided. The service provides support to adults with learning disabilities and autism. At the time of our inspection there were 26 people using the service.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
People’s experience of using this service and what we found
We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.
Right Support
Staff were committed to supporting people in line with their preferences and supported people to receive their medicines. However, we found people’s medicines were not always managed safely. High level assurances were provided by the management team this area would be addressed. People’s independence was promoted, and staff encouraged people to take control of their own care. People’s care and support needs were assessed in a person-centred way and risks associated with the provision of people’s care were assessed to ensure support was provided safely. Where people's needs were complex, the service would call upon the experience of their positive behaviour specialist who worked hard to create plans so care could continue safely.
Right Care
People and their relatives were pleased with their care and support. Staff were kind and respectful, upholding people's right to privacy and dignity. They understood and responded to individuals needs in a way they were comfortable with. People had access to health care professionals when they needed them. Medicines were administered safely.
Right Culture
People received quality care and support because staff worked closely with the registered manager and demonstrated a commitment to positive outcomes for people. Staff received regular supervision and support. The registered manager had invested time and effort in developing staff skills and confidence, delegating tasks with support so staff felt more able to manage a range of situations in the registered manager's absence.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
This service was registered with us on 5 February 2021 and this is the first inspection. The last rating for the service under the previous provider was good.
Why we inspected
This inspection was prompted by a review of the information we held about this service.
Enforcement
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.
We have identified a breach in relation to safe management of medicines at this inspection.
Please see the action we have told the provider to take at the end of this report.
Follow up
We will request an action plan from the provider to understand what they will do to improve their medicines systems. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.